Helistroke: Physician-to-Patient Model That May Change Stroke Treatment
Transporting a stroke specialists direct to a patient via helicopter may be a practical and realistic method to improve outcomes. A Johns Hopkins Medicine research team conducted a proof-of-concept study of a ‘helistroke service', transporting a physician by helicopter to perform a standard intervention for stroke.
The researchers at Johns Hopkins chose Suburban Hospital in Washington, D.C. as their location for physician transfer. This is due to the hospital's location – being part of Johns Hopkins Health System – and despite the hospital having radiologists and equipment to image blood vessels, it has no neurointerventional experts on hand to provide immediate, catheter-based treatment.
The prospective patient for the pilot study had to have a large vessel blockage and a National Institutes of Health Stroke Scale rating greater than 8. Such a patient was identified in Suburban at 11:12am of January this year. Scans of the patient's blood vessels and brain tissue were completed at 11:58am and the physician chosen to treat the patient, Dr. Ferdinand Hui, was informed at 12:07pm. The Johns Hopkins Lifeline helicopter was cleared for takeoff at 12:24pm and the journey to Suburban Hospital took 19 minutes.
The time it took for the decision-to-treat with the catheter to groin closure was 77 minutes, which is similar to treatment in one institution without transfer. The patient subsequently received tissue Plasminogen Activator and improved clinically.
Doctor Hui noted that the helistroke service model could be expanded to improve standards of care in rural areas and other places where specialized care is limited. “Up until now, the model has been that the 'right place' was a central location, like a tertiary facility," said Jim Scheulen, MBA, chief administrative officer of emergency medicine at Johns Hopkins Hospital. “But what we have demonstrated here is that bringing the right resources in the right time to the patient may actually be a better approach than always moving the patient.”
Compared to the average cost of transferring a patient by helicopter ($6,500-$8,000), the cost of transferring a physician in this case was roughly 20% cheaper ($2,000-$3,000) for the hospital network.
For more information visit Hopkinsmedicine.org.